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Everyone feels low sometimes. Depression is different, and most people who have it benefit from treatment.
Maybe it started slowly. Things you used to enjoy feel flat. Getting out of bed takes more effort than it should, and even small tasks, like answering a text or making dinner, can feel like too much. You might tell yourself it is just a rough stretch, and wait for it to pass. Sometimes it does. Sometimes it does not.
If this sounds familiar, it can help to understand what depression is and how it shows up. This post covers how depression differs from ordinary sadness, the signs to watch for, the main types, and what treatment looks like. If you want to check in with yourself first, our post Am I depressed? is a gentle place to start.
Why depression is more than feeling sad
Sadness is part of being human. A loss, a disappointment, or a hard week can leave anyone feeling low. For most people, those feelings ease with time.
Depression works differently. The National Institute of Mental Health describes it as a condition that can cause severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working. It is sometimes called major depressive disorder or clinical depression.
One of the clearest differences is how long it lasts. According to NIMH, to be diagnosed with depression, a person has symptoms most of the day, nearly every day, for at least two weeks. It is not something a person can simply decide to snap out of.
How common depression is
Depression is common. NIMH estimates that in 2021, about 21 million adults in the United States, or 8.3% of all adults, had at least one major depressive episode. It was more common among women (10.3%) than men (6.2%).
NIMH also notes that depression can affect anyone, regardless of age, sex, race or ethnicity, income, culture, or education.
As for causes, NIMH says research suggests that genetic, biological, environmental, and psychological factors all play a role.
Common signs of depression
Depression looks different from person to person. Not everyone has every symptom, and some people have only a few. The signs NIMH lists tend to fall into four groups.
1. Mood
- A sad, anxious, or “empty” mood that does not lift
- Feeling hopeless or pessimistic
- Feeling irritable, frustrated, or restless
2. Thoughts
- Feeling guilty, worthless, or helpless
- Trouble concentrating, remembering, or making decisions
- Thoughts of death or suicide
3. Energy and daily life
- Losing interest or pleasure in hobbies and activities
- Feeling tired, low on energy, or slowed down
- Trouble sleeping, waking too early, or sleeping too much
- Changes in appetite, or weight changes that were not planned
4. The body
- Aches or pains, headaches, cramps, or digestive problems without a clear physical cause, which do not go away with treatment
Physical symptoms can be easy to miss, since they may not seem connected to mood at first.
How depression can show up in everyday life
Lists of symptoms can feel abstract. Day to day, depression can look quieter than people expect.
For some people, it shows up as pulling back. Plans get canceled, calls go unanswered, and time alone starts to feel easier than time with others. For others, it looks like irritability, where small things set off frustration that is hard to explain. Some people keep going to work and handling their responsibilities, but feel like they are running on empty the whole time. From the outside, they may look fine.
Some people are also hard on themselves about it. They may wonder why they cannot just push through, or compare themselves to others who seem to be doing better. That kind of self-criticism can make it harder to reach out, even when support would help.
Types of depression
Depression is not just one thing. NIMH describes several forms, including:
- Major depression: a depressed mood or loss of interest, most of the time for at least two weeks, that gets in the way of daily life.
- Persistent depressive disorder: less severe symptoms that last much longer, usually at least two years. You can read more in our post on persistent depressive disorder.
- Seasonal affective disorder: depression that comes and goes with the seasons, usually starting in late fall and early winter. Our post on managing seasonal depression covers this in more detail.
- Perinatal depression: depression during pregnancy or after childbirth, which is more than the “baby blues.” See our post on postpartum depression.
- Depression with psychosis: a severe form in which a person also has symptoms such as delusions or hallucinations.
NIMH also notes that bipolar disorder involves depressive episodes along with manic or hypomanic episodes. Our post on bipolar disorder explains the difference.
How depression is treated
The encouraging part is that, according to NIMH, most people with depression benefit from mental health treatment. Once treatment begins, people should gradually start to feel better.
Talk therapy is one option. Two approaches NIMH names are:
- Cognitive behavioral therapy (CBT), where people learn to challenge and change unhelpful thoughts and behaviors. Our post on cognitive behavioral therapy explains how it works.
- Interpersonal therapy (IPT), which focuses on the relationships and life events that affect mood, and the ways mood affects them in return.
Medication is another option. According to NIMH, antidepressants usually take four to eight weeks to work, and problems with sleep, appetite, and concentration often improve before mood lifts. NIMH advises talking to a health care provider before starting or stopping any medication.
NIMH also describes brain stimulation therapies, which are sometimes used earlier when severe depression has become life-threatening. The most used are electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS).
Daily habits can support treatment too. NIMH suggests trying to get physical activity, keeping regular sleep and wake times, eating regular meals, talking with people you trust, and avoiding alcohol and drugs.
If someone you care about may be depressed
Sometimes the person struggling is not you, but someone close to you. It can be hard to know what to say.
- Listen more than you advise. Letting someone talk without rushing to fix things can mean a lot.
- Offer practical help. A meal, a ride, or help making a first phone call can lower the barrier to getting support.
- Encourage professional help, gently. You might offer to help them look for a therapist or sit with them while they book an appointment.
- Take talk of suicide seriously. If they mention wanting to die or hurting themselves, call or text 988 together, or call 911 if they are in immediate danger.
When depression needs more support
It may be time to reach out for help if:
- Low mood or loss of interest has lasted two weeks or more
- Sleep, work, or relationships are being affected
- Things that used to help are not helping anymore
- You are leaning on alcohol or other substances to get through the day
- You have thoughts of death or of hurting yourself
If you are having thoughts of suicide or feel unsafe, call or text 988 to reach the 988 Suicide & Crisis Lifeline, any time of day. In an emergency, call 911.
Therapy for depression at Panahi Counseling
Reaching out when you feel low can be hard, since depression itself can make everything feel like more effort. It can help to know the first step can be small.
At Panahi Counseling, our therapists work with adults across Illinois who are living with depression, whether it came on recently or has been around for years. Our depression therapy draws on approaches like cognitive behavioral therapy, and the work is shaped around your life and pace. You can read about our therapists to see who might be a good fit.
If you live in Illinois and are looking for a therapist, we offer in-person sessions in Wheaton and online therapy across the state. You are welcome to start with a free 15-minute consultation. It is a low-pressure way to ask questions and see whether it feels right.
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If you're seeing yourself in what you just read, that awareness is a real first step. Our therapists in Wheaton, IL specialize in depression therapy and can help you start feeling like yourself again.
